“Herbal” Sexual Enhancement Products: Why Are Medicines Found in Pastes, Capsules and Chocolates? What Are the Risks?
Some pastes, capsules, honey mixtures and chocolates sold as “herbal” or “natural” may contain an undeclared prescription erection drug, or similar variants never tested in humans. Why these products are risky, which medicines make them dangerous, how to spot a suspicious one and what users should do are covered here.
A man who has been struggling with erections for a while sees a post on social media, or a friend tells him “try this, it's herbal, it can't do any harm”, and he ends up with a jar of paste, a few capsules or a bar of chocolate. When it works quickly he feels relieved; he usually does not mention it to his doctor or consider whether it is safe alongside his other medicines.
What draws men to these products is usually embarrassment, reluctance to see a doctor for a prescription or the belief that “natural means harmless”. Yet in recent years, inspections in both Turkey and Europe have found that some sexual enhancement products sold as “herbal” or “natural” contained the active ingredient of a prescription erection drug, or similar chemical variants never tested in humans; these products were recalled and announced to the public. This article explains the risks of these products, dangerous drug combinations, how to recognise a suspicious product and what to do if one has been used.
Which products are involved?
These are products sold with promises of “sexual power”, “performance” or “delay” that have no licence as medicines:
- Pastes and honey mixtures: Sold in jars or single-use sachets.
- Capsules, tablets and syrups: Usually promoted as “herbal supplements”.
- Chocolate and coffee mixtures: Assumed to be harmless because they look like food.
- “Delay” products: Pills, sprays and creams for premature ejaculation; undeclared medicinal ingredients have been reported in some.
They are mostly sold via social media, messaging groups and websites, or hand to hand. In Turkey, selling prescription medicines online is prohibited, and food supplements cannot be sold with claims that they treat a disease.
Why are medicines being found in these products?
Because the effect of herbal ingredients on erections is uncertain, some manufacturers secretly add the active ingredient of a prescription erection drug, a PDE5 inhibitor, to create the impression that the product “works”. The label lists only ingredients such as plants, honey or cocoa; the drug is not declared.
More worrying still are similar variants, produced by altering the chemical structure of approved drugs to evade inspections. These have never been tested in humans; how long they stay in the body, what side effects they cause and how they interact with other medicines are unknown. A single product may contain more than one hidden substance. The real problem is that the substance is taken unknowingly, in an unknown amount.
Why are an unknown dose and unknown contents dangerous?
In a prescription medicine, the amount of active ingredient per tablet is fixed and the doctor adjusts the dose to the person's health. In these products, the amount can vary from batch to batch; some analyses have found amounts far above the therapeutic dose. Possible problems include:
- Side effects: Headache, facial flushing, palpitations, dizziness, a drop in blood pressure, and blurred vision or changes in colour vision.
- Prolonged, painful erection (priapism): An erection lasting more than four hours is an emergency; delay can cause lasting damage to penile tissue.
- Contamination: As production conditions are unknown, there is no assurance against microbial contamination or contaminants such as heavy metals.
The riskiest combinations: heart and blood pressure medicines
The real danger of a hidden erection drug appears alongside certain medicines and conditions:
- Nitrate-group chest pain medicines: Combined with erection drugs, they can cause a serious, dangerous drop in blood pressure; in prescribed treatment this combination is strictly avoided.
- Alpha blockers and blood pressure medicines: Used for an enlarged prostate or high blood pressure, these can add to the risk of dizziness and fainting.
- Medicines that slow the drug's clearance: Certain antifungal medicines and antibiotics can strengthen and prolong its effect.
- Heart disease: In serious heart disease, the strain the drug and sexual activity place on the heart should be assessed first.
A prescribing doctor asks about these; with these products, the person does not know he is taking a drug and so does not tell his doctor or the emergency department, which is the most dangerous point. For example, a man who arrives with chest pain without mentioning the product may be given a nitrate-group medicine.
Why does a “natural” label offer no reassurance?
“Natural” does not mean safe. Plants also contain active substances; they can cause side effects, drug interactions and allergic reactions. For most herbal ingredients sold for sexual performance, an effect on erections has not been shown in reliable, well-designed studies; the available data are limited or conflicting.
So a marked effect from the very first use does not make a product safe; on the contrary, it often points to a hidden drug added to it.
How can the product mask the real problem?
Erectile dysfunction is often a sign of another condition; underlying causes can include:
- Vascular and heart health: An erection problem can be an early sign of cardiovascular disease.
- Diabetes: Undiagnosed or poorly controlled diabetes can affect nerves and blood vessels.
- Hormonal problems: Testosterone deficiency can affect erections and sexual desire.
- Medication side effects: Some blood pressure, depression and prostate medicines can affect sexual function.
- Anxiety and relationship factors: Performance anxiety, stress and relationship difficulties also play an important part.
“Managing” the problem with a product can delay the diagnosis of these causes by months or even years. Yet once the cause is found, most of these conditions can be treated or brought under control.
How can you recognise a suspicious product?
The following signs suggest that a product may contain an undeclared drug:
- Exaggerated promises: Phrases such as “works in 30 minutes”, “no side effects”, “completely natural”, “prescription-drug effect without a prescription” or “lasts for days”.
- Missing label information: No manufacturer name or address, ingredient list or authorisation details; a label only in a foreign language.
- Leaflet-style warnings: Phrases such as “not for use by people taking heart medicines”.
- How it is sold: Only via social media, messaging apps or hand to hand; “discreet packaging” offered.
Even without these signs a product is not necessarily safe; an approval or registration number on the packaging does not by itself mean the contents are correctly declared.
What should you do if you have used such a product?
If any of the following develops after taking the product, call emergency services (112 in Turkey) or go to an emergency department without delay:
- Heart and circulation symptoms: Chest pain, shortness of breath, feeling faint or marked dizziness.
- Sensory loss: Sudden loss of vision or hearing.
- Prolonged erection: An erection lasting more than four hours, or a painful one.
At the emergency department, always mention the product and, if possible, bring its packaging; this is needed so that treatment can be chosen safely. Without these symptoms, stopping the product and showing it, with its packaging, to a doctor is advised. Do not stop prescribed medicines on your own; if a change is needed, discuss it with the doctor who prescribed them. Everything shared in the consultation is handled in confidence and without judgement.
When should you see a doctor?
A urology and andrology assessment is advised in the following situations:
- Use of a “herbal” sexual enhancement product, especially alongside heart, blood pressure or prostate medicines
- Headache, palpitations, dizziness or changes in vision after using the product
- An erection problem that has lasted for several months or is getting worse
- An erection problem accompanied by diabetes, high blood pressure, weight gain or reduced sexual desire
- Erections that can be achieved only with such a product
Sexual enhancement products sold as “herbal” are uncertain in both content and dose; the hidden drugs they may contain can have serious consequences, particularly alongside heart and blood pressure medicines. An erection problem, by contrast, is often a condition whose cause can be found and treated safely; prescription treatments are used under medical supervision after examination, with the person's heart health and medicines known. Assoc. Prof. Zülfü Sertkaya practises in urology and andrology in Istanbul; assessment and treatment planning for erection problems are carried out with individual assessment and confidentiality.